Medication Administration

The study of drug concentration

• Pharmacokinetics
• Growth and development
• Nutrition
• Mathematics

• Designated official standards for medications;
• specified standards for medication labeling especially those that were habit forming;
• also established the Food and Drug Administration (FDA)

This voluntary program encourages nurses and other health care professionals to report when a medication, product, or medical event causes serious harm to a client by completing the MedWatch form

• provides an exact description of the medication's composition and molecular structure.
• Nurses rarely use chemical names in clinical practice.
• An example of a chemical name is N-acetyl-para-aminophenol. =Tylenol

• a non-proprietary name
• The generic name becomes the official name listed in official publications such as the USP
• example is acetominaphen = tylenol

• The trade name, brand name, or proprietary name is the name under which a manufacturer markets a medication.
• The trade name has the symbol™ at the upper right of the name, indicating that the manufacturer has trademarked the medication's name

• Store all narcotics in a locked, secure cabinet or container
• •Narcotics are frequently counted. Usually counts are made on a continuous basis with the opening of narcotic drawers and/or at shift change.
• •Report discrepancies in narcotic counts immediately.
• •Use a special inventory record each time a narcotic is dispensed. Records are often kept electronically and provide an accurate ongoing count of narcotics used and remaining as well as information about narcotics that are wasted
• .•Use the record to document the client's name, date, time of medication administration, name of medication, dose, and signature of nurse dispensing the medication.
• •If a nurse gives only part of a premeasured dose of a controlled substance, a second nurse witnesses disposal of the unused portion. This must be recorded

• the effect of the medication on a body system
• the symptoms the medication relieves
• or the medication's desired effect

• the route of administration,
• ability of the medication to dissolve,
• blood flow to the site of administration,
• body surface area,
• and lipid solubility of medication.

Liquids

lozenges

on mucous membranes and respiratory airways because these tissues contain so many blood vessels

they must pass through the GI tract

they enter systemic circulation

• large.
• This is why the majority of medications are absorbed in the small intestine rather than the stomach.

quickly.

the expected or predictable physiological response a medication causes

predictable and often unaviodable secondary effects produced at a usual therapeutic dose.

• unintended, undesirable, and often unpredictable severe responses to medications
• may often take weeks or months to develop
• early recognition is key

develop after prolonged intake of a medication or when a medication accumulates in the blood because of impaired metabolism or excretion

• overreaction or underreaction of a medication or a reaction that is different from normal.
• ie children that takes benedryl becomes agitated and excited instead of drowsy
• not always predictable

• unpredictable responses to a medication.
• Some clients become immunologically sensitized to the initial dose of a medication.
• With repeated administration, the client develops an allergic response to the medication, its chemical preservatives, or a metabolite.
• The medication or chemical acts as an antigen, triggering the release of the body's antibodies.

• life threatening or severe allergic reactions
• characterized by sudden constriction of bronchiolar muscles, edema of the pharynx and larynx, and severe wheezing and shortness of breath.

under the tongue

when a medication is pushed against the cheek and absorbed through cappilaries

the combined effect of the two medications is greater than the effect of the medications when given separately

the time it takes for excretion processes to lower the serum medication concentration by half

the time it takes for the medication to produce a response

Minimum blood serum concentration of medication reached just before the next scheduled dose

Blood serum concentration of a medication reached and maintained after repeated fixed doses

• Sublingual
• Buccal

• 1.Intradermal (ID): Injection into the dermis just under the epidermis
• 2.Subcutaneous (Sub-Q): Injection into tissues just below the dermis of the skin
• 3.Intramuscular (IM): Injection into a muscle
• 4.Intravenous (IV): Injection into a vein

• skin
• mucous membranes (includes vaginal and rectal)
• inhalation
• intraocular
• otic (ear)
• nasal

• Circulation: Heart rate, blood volume (if u are anemic or low blood volume=slow down)
• Permeability: does it pass placental barrier? Does pass the blood brain barrier?
• Protien binding: the degree by which the med binds to proteins, such as albumin. (albumin decreases in geriatric population which increases the risk of toxic effects

usually in the liver

the lungs

• a form of synergistic effect
• 2 meds given together that gives an increased effect of one of the medications

2 meds given together that decreases or slows down the effect of one of the medications

• a nurse practioner
• physician
• physicians assistnat

is carried out until the prescriber cancels it by another order or until a prescribed number of days elapse

A now order is more specific than a one-time order and is used when a client needs a medication quickly but not right away, as in a STAT order

a 24 hour dose of meds the pt takes

Special medication rooms, portable locked carts, computerized medication cabinets, and individual storage units next to clients' rooms are examples of storage areas used

• Right:
• medicaton
• dose
• patient
• route
• time
• documentation

Medication administration record

Aseptic

tuberculin syringe

• outer posterior aspects of the arm
• abdomen above ileac crest
• anterior aspects of the thighs
• 45-90 degrees

• 90 degrees
• Ventrogluteal: find ball of femur and hip bone
• Vastus Lateralus: one hand above the knee and other below groin. frequently used in infants
• deltoid: where scapula meets clavicle. not used in pts with underdeveloped muscles ( infants). used in toddlers older children and adults
• ...faster absorption than SubQ
• Use Z track method

• are used for skin testing (tb)
• 5- 15 degrees

• pain meds
• they are concentrated and then introduced into systemic circulation
• rapid onset